Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China (all authors).
Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China (all authors)..
J Minim Invasive Gynecol. 2019 Mar-Apr;26(3):409-416. doi: 10.1016/j.jmig.2018.09.772. Epub 2018 Sep 22.
In this review, we assessed the short-term (3 and 6 months) and long-term (12, 24, and 36 months) symptom relief and quality of life improvement, procedure-related adverse event rate, reintervention rate, and days missed from work after laparoscopic radiofrequency ablation. Using MeSH keywords "uterine fibroid" and "ablation technique," a systematic search was performed in PubMed, Ovid, Embase, Cochrane Library, and Clinicaltrials.gov. Studies consisting of uterine fibroid symptoms and quality of life scores were considered eligible. Both comparative and noncomparative studies were included. Using a random-effects model, a meta-analysis was performed. Eight studies with a total of 581 patients were finally included in our review. Based on validated questionnaires, quality of life improved significantly until 36 months after laparoscopic radiofrequency ablation therapy, with a maximum improvement (Health-Related Quality of Life [HRQL] questionnaire score of +41.64 [95% confidence interval (CI), 38.94-44.34] and a transformed Symptom Severity Score [tSSS] of -39.37 [95% CI, 34.70-44.04]) at 12 months after laparoscopic radiofrequency ablation. All subscales of quality of life improved significantly, and most of the changes remained stable in long-term follow-up. The overall reintervention rate was 4.39% (95% CI, 1.60%-8.45%), and the median uterine volume reduction was 69.17 cm³ (95% CI, 35.87-102.46 cm³).The overall procedure-related adverse events rate was 1.78% (95% CI, 0.62%-3.53%), and patients missed an average of 4.35 days (95% CI, 2.55-6.15 days) of work. In conclusion, laparoscopic radiofrequency ablation therapy is an efficacious way to treat small-sized and nonpedunculated symptomatic uterine fibroids, providing stable long-term symptom relief and quality of life improvement with a low risk of adverse events and reintervention and just a few days of missed work.
在这项综述中，我们评估了腹腔镜射频消融术的短期（3 个月和 6 个月）和长期（12 个月、24 个月和 36 个月）症状缓解和生活质量改善、与手术相关的不良事件发生率、再次干预率以及术后误工天数。使用 MeSH 关键词“子宫肌瘤”和“消融技术”，在 PubMed、Ovid、Embase、Cochrane 图书馆和 Clinicaltrials.gov 进行了系统检索。只有包含子宫肌瘤症状和生活质量评分的研究才符合纳入标准。纳入了比较性和非比较性研究。使用随机效应模型进行了荟萃分析。最终，我们的综述共纳入了 8 项研究，共计 581 例患者。基于有效的问卷，腹腔镜射频消融治疗后 36 个月内生活质量显著改善，最大改善（健康相关生活质量问卷评分+41.64[95%置信区间（CI），38.94-44.34]和转化后的症状严重程度评分-39.37[95%CI，34.70-44.04]）发生在腹腔镜射频消融治疗后 12 个月。所有生活质量的亚量表均显著改善，且大多数变化在长期随访中保持稳定。总的再次干预率为 4.39%（95%CI，1.60%-8.45%），子宫体积中位数缩小 69.17cm³（95%CI，35.87-102.46cm³）。总的与手术相关的不良事件发生率为 1.78%（95%CI，0.62%-3.53%），患者平均误工 4.35 天（95%CI，2.55-6.15 天）。总之，腹腔镜射频消融术是治疗小尺寸、非蒂部有症状的子宫肌瘤的有效方法，可提供稳定的长期症状缓解和生活质量改善，不良事件和再次干预的风险低，且仅需几天的误工。
